Axios Pro: Health Tech Deals

July 01, 2022

Axios Pro Exclusive Content

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1 big thing: Health tech companies at center of transparency rule

Illustration of a caduceus with a price tag
Illustration: Natalie Peeples/Axios

Patients will soon have a clearer picture of what insurers and employers pay for health care thanks to a federal rule that kicks in today β€” if a collection of health tech companies can make the trove of data understandable, Axios' Tina Reed writes.

Why it matters: Patients often have no idea what a procedure or service costs β€” and have little ability to comparison shop β€” until they're left holding the bag with a higher bill than they expected.

Driving the news: Starting today, insurers will have to list their negotiated rates with in-network providers, as well as out-of-network allowed amounts and billed charges for certain items and services.

  • It's part of a Trump-era price transparency rule that also requires hospitals to start posting negotiated rates in 2021. Enforcement of the payer version of the rule was delayed until July 1, 2022.
  • Insurers who don't release the info will face a penalty of $100 per person per day per violation.

What they are saying: "It's like the biggest milestone in U.S. health since the ACA was rolled out," said Chris Severn, co-founder and CEO of Turquoise Health, a San Diego-based tech startup that works with price transparency data.

  • "On all these insurance company websites, in all of these files, the real price of health care is coming out. Not just for hospitals, but for all types of services," Severn told Axios.

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